scholarly journals Systemic Inflammatory Responses in Children with Acute Otitis Media Due to Streptococcus pneumoniae and the Impact of Treatment with Clarithromycin

2003 ◽  
Vol 10 (4) ◽  
pp. 721-724 ◽  
Author(s):  
Gunter Scharer ◽  
Frank Zaldivar ◽  
Guillermo Gonzalez ◽  
Ofelia Vargas-Shiraishi ◽  
Jasjit Singh ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Antibiotic Treatment ◽  
Statistical Significance ◽  
Objective Assessment ◽  
Acute Otitis Media ◽  
Serum Levels ◽  
Asymptomatic Children ◽  
Tnf Α ◽  
The Impact

ABSTRACT This pilot study was designed to determine the serum cytokine profile of acute otitis media (AOM) due to Streptococcus pneumoniae and the impact of clarithromycin (Abbott Laboratories, Inc). Serum levels of interleukin-1β (IL-1β), tumor necrosis factor alpha (TNF-α), IL-6, and IL-8 were measured at diagnosis and 3 to 5 days after start of antibiotic treatment in 10 patients (mean age, 18.3 ± 13.9 months) who had middle ear fluid culture positive for S. pneumoniae. The mean concentrations of all cytokines were elevated at diagnosis of AOM compared to levels in healthy controls, yet only IL-6 reached statistical significance (P = 0.05). IL-6 showed a statistically significant decrease in mean serum concentration at visit 2 (P = 0.03). IL-8 displayed a similar pattern to IL-6, but the difference between samples from day 1 and day 2 did not reach statistical significance. The cytokines IL-1β and TNF-α appear to be elevated in the serum of patients with S. pneumoniae AOM, but there was no significant change between mean serum levels obtained pre- and postinitiation of antibiotic treatment in the time frame studied. The results suggest a systemic inflammatory response as evidenced by increased IL-6. A significant decrease of IL-6 and improvement of clinical symptoms were observed. Determining cytokine levels, especially IL-6, in AOM could offer a powerful tool for objective assessment of response to treatment, minimizing unnecessary treatment of asymptomatic children who may still have some otoscopic findings suggestive of AOM at follow-up visits.

scholarly journals Effect of Antibiotic Treatment Delay on Therapeutic Outcome of Experimental Acute Otitis Media Caused by Streptococcus pneumoniae Strains with Different Susceptibilities to Amoxicillin

2004 ◽  
Vol 48 (3) ◽  
pp. 860-866 ◽  
Author(s):  
Araceli Parra ◽  
Carmen Ponte ◽  
Carlos Cenjor ◽  
Carmen Martínez-Marín ◽  
Francisco Soriano
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Antibiotic Treatment ◽  
Acute Otitis Media ◽  
Antibiotic Administration ◽  
Bacterial Inoculation ◽  
Antibiotic Resistant ◽  
Selection Of ◽  
Antibiotic Resistant Mutants

ABSTRACT The effect of delayed administration of amoxicillin on the course of acute otitis media (AOM) caused by two Streptococcus pneumoniae strains with different susceptibilities to amoxicillin (MICs of 0.016 and 1 μg/ml for strains A and B, respectively) was evaluated in the gerbil model. The organisms were inoculated by transbullar challenge into the middle ear, and antibiotic treatment was administered at various times thereafter. The bacteriological and clinical efficacies of treatment diminished significantly with the delay of antibiotic administration. The bacterial eradication rates when antibiotic treatment was started at 2, 5, 8, 18, and 21 h post-bacterial inoculation were different for both strains (95, 95, 90, 55, and 55% for strain A and 95, 95, 65, 10, and 0% for strain B). Results of further experiments using strain B with higher antibiotic doses and numbers of administrations and different follow-up times indicate that the failures observed with the delayed administration were not related to the bacterial burden, selection of antibiotic-resistant mutants, or inadequate pharmacodynamic parameters. Such failures may be related to the metabolic bacterial status. The delayed amoxicillin treatment of AOM caused by S. pneumoniae may lead to therapeutic failures, mainly when organisms with diminished antibiotic susceptibility are involved.

scholarly journals PDG4 THE IMPACT OF ANTIBIOTIC TREATMENT TIME AND CLASS OF ANTIBIOTIC FOR ACUTE OTITIS MEDIA INFECTIONS ON THE RISK OF REVISITS

2019 ◽  
Vol 22 ◽  
pp. S163
Author(s):  
K. Sangha ◽  
I. Steinberg ◽  
J.S. McCombs
Keyword(s):  
Otitis Media ◽  
Antibiotic Treatment ◽  
Treatment Time ◽  
Acute Otitis Media ◽  
The Impact

scholarly journals Streptococcus pneumoniae burden and nasopharyngeal inflammation during acute otitis media

2017 ◽  
Vol 23 (8) ◽  
pp. 667-677 ◽  
Author(s):  
Matthew C Morris ◽  
Michael E Pichichero
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Neutrophil Recruitment ◽  
Respiratory Pathogen ◽  
Bacterial Burden ◽  
Nasal Wash ◽  
Upper Respiratory Infection ◽  
Tnf Α ◽  
Upper Respiratory

Streptococcus pneumoniae (Spn) is a common respiratory pathogen and a frequent cause of acute otitis media (AOM) in children. The first step in bacterial pathogenesis of AOM is the establishment of asymptomatic colonization in the nasopharynx. We studied Spn bacterial burden in conjunction with neutrophil recruitment and inflammatory gene transcription and cytokine secretion in samples of nasal wash collected from normal and otitis-prone children during health, viral upper respiratory infection without middle ear involvement (URI) and AOM. We found no significant associations between otitis-prone status and any of the measured parameters. However, Spn bacterial burden was significantly correlated with neutrophil recruitment, transcription of IL-8, TNF-α and SOD2, and secretion of TNF-α. We also found that transcription of IL-8 and TNF-α mRNA by neutrophils was significantly correlated with the secretion of these cytokines into the nasopharynx. We conclude that Spn bacterial burden in the NP is a major determinant of neutrophil recruitment to the NP and activity during URI and AOM, and that neutrophils are contributors to the secretion of IL-8 and TNF-α in the NP when the Spn burden is high.

Microbiology of acute otitis media with perforation (AOMwiP) in Aboriginal children living in remote communities—monitoring the impact of 7-valent pneumococcal conjugate vaccine (7vPCV)

2006 ◽  
Vol 1289 ◽  
pp. 89-92 ◽  
Author(s):  
Amanda Leach ◽  
Grant MacKenzie ◽  
Kim Hare ◽  
Elizabeth Stubbs ◽  
Jemima Beissbarth ◽  
...  
Keyword(s):  
Otitis Media ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Acute Otitis Media ◽  
Remote Communities ◽  
Aboriginal Children ◽  
The Impact

scholarly journals Development of an electronic conversation aid to support shared decision making for children with acute otitis media

JAMIA Open ◽  
2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Jana L Anderson ◽  
e Silva Lucas Oliveira J ◽  
Juan P Brito ◽  
Ian G Hargraves ◽  
Erik P Hess
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Medical Knowledge ◽  
Complication Rates ◽  
Shared Decision ◽  
Web Based ◽  
Quality Issue ◽  
The Impact

Abstract Objective The overuse of antibiotics for acute otitis media (AOM) in children is a healthcare quality issue in part arising from conflicting parent and physician understanding of the risks and benefits of antibiotics for AOM. Our objective was to develop a conversation aid that supports shared decision making (SDM) with parents of children who are diagnosed with non-severe AOM in the acute care setting. Materials and Methods We developed a web-based encounter tool following a human-centered design approach that includes active collaboration with parents, clinicians, and designers using literature review, observations of clinical encounters, parental and clinician surveys, and interviews. Insights from these processes informed the iterative creation of prototypes that were reviewed and field-tested in patient encounters. Results The ear pain conversation aid includes five sections: (1) A home page that opens the discussion on the etiologies of AOM; (2) the various options available for AOM management; (3) a pictograph of the impact of antibiotic therapy on pain control; (4) a pictograph of complication rates with and without antibiotics; and (5) a summary page on management choices. This open-access, web-based tool is located at www.earpaindecisionaid.org. Conclusions We collaboratively developed an evidence-based conversation aid to facilitate SDM for AOM. This decision aid has the potential to improve parental medical knowledge of AOM, physician/parent communication, and possibly decrease the overuse of antibiotics for this condition.

Increasing Importance of Multidrug-Resistant Serotype 6A Streptococcus pneumoniae Clones in Acute Otitis Media in Southern Israel

2010 ◽  
Vol 29 (2) ◽  
pp. 126-130 ◽  
Author(s):  
Nurith Porat ◽  
Uri Amit ◽  
Noga Givon-Lavi ◽  
Eugene Leibovitz ◽  
Ron Dagan
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Multidrug Resistant
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